Cost-efficacy of cultured epidermal autografts in massive pediatric burns

Juan P. Barret, Steven Wolf, Manubhai H. Desai, David Herndon

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Objective: To assess the efficacy of cultured epidermal autografts (CEA) for closure of burn wounds in pediatric burn patients with full-thickness burns of more than 90% total body surface area. Summary Background Data: Paucity of donor sites in massive burns makes the use of expanded skin of paramount importance. CEA techniques have been used in burned patients with differing and controversial results. The true impact and the efficacy of such techniques in massive burns remain uncertain. Methods: Patients with full- thickness burns of more than 90% body surface area treated between May 1988 and May 1998 were studied. Patients grafted with CEA were compared with patients grafted with conventional meshed autografts. Rates of death and complications, length of hospital stay (LOS), hospital cost, acute readmissions for reconstruction, and quality of scars were studied as outcome measures. Results: Patients treated with CEA had a better quality of burn scars but incurred a longer LOS and higher hospital costs. Both groups had comparable readmissions for open wounds, but patients treated with CEA required more reconstructive procedures during the first 2 years after the injury. The incidence of sepsis and pneumonia in both groups was comparable. Conclusions: Conventional meshed autografts are superior to CEA for containing hospital cost, diminishing LOS, and decreasing the number of readmissions for reconstruction of contractures. However, the use of CEA provides better scar quality such that perhaps future research should focus on bioengineered dermal templates to promote take and diminish long-term fragility.

Original languageEnglish (US)
Pages (from-to)869-876
Number of pages8
JournalAnnals of Surgery
Volume231
Issue number6
DOIs
StatePublished - Jun 2000

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Autografts
Burns
Pediatrics
Costs and Cost Analysis
Length of Stay
Hospital Costs
Cicatrix
Body Surface Area
Wounds and Injuries
Skin
Contracture
Sepsis
Pneumonia
Outcome Assessment (Health Care)
Tissue Donors
Mortality
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Cost-efficacy of cultured epidermal autografts in massive pediatric burns. / Barret, Juan P.; Wolf, Steven; Desai, Manubhai H.; Herndon, David.

In: Annals of Surgery, Vol. 231, No. 6, 06.2000, p. 869-876.

Research output: Contribution to journalArticle

Barret, Juan P. ; Wolf, Steven ; Desai, Manubhai H. ; Herndon, David. / Cost-efficacy of cultured epidermal autografts in massive pediatric burns. In: Annals of Surgery. 2000 ; Vol. 231, No. 6. pp. 869-876.
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